The heart's content: The association between positive psychological well-being and cardiovascular health.

Abstract

This review investigates the association between positive psychological well-being (PPWB) and cardiovascular disease (CVD). We also consider the mechanisms by which PPWB may be linked with CVD, focusing on the health behaviors (e.g., smoking, alcohol consumption, physical activity, sleep quality and quantity, and food consumption) and biological functions (e.g., cardiovascular, inflammatory, and metabolic processes) that are most relevant for cardiovascular health. Because PPWB is a broad concept, not all aspects of PPWB may be associated with cardiovascular health. Thus, we distinguish between eudaimonic well-being, hedonic well-being, optimism, and other measures of well-being when reviewing the literature. Findings suggest that PPWB protects consistently against CVD, independently of traditional risk factors and ill-being. Specifically, optimism is most robustly associated with a reduced risk of cardiovascular events. In general, PPWB is also positively associated with restorative health behaviors and biological function and inversely associated with deteriorative health behaviors and biological function. Cardiovascular health is more consistently associated with optimism and hedonic well-being than with eudaimonic well-being, although this could be due in part to more limited evidence being available concerning eudaimonic well-being. Some similarities were also evident across different measures of PPWB, which is likely due to measurement overlap. A theoretical context for this research is provided, and suggestions for future research are given, including the need for additional prospective investigations and research that includes multiple constructs of psychological well-being and ill-being.Keywords: cardiovascular disease, health behaviors, biological function, eudaimonic well-being, hedonic well-being Scholars have long recognized the connection between mental health and physical health. From the ancient Roman poet Juvenal who declared, "A healthy mind in a healthy body," to early 20th century psychoanalysts who investigated the connection between mental states and physiology (Menninger & Menninger, 1936), and to researchers in the late 20th century seeking to identify disease-prone personalities (H. S. Friedman & Booth-Kewley, 1987;Rosenman et al., 1964), the complex relationship between psychological attributes and physical ailments has been the subject of fascination across time. Although past research has predominantly focused on the relationship between poor psychological functioning (e.g., anxiety, depression, hostility) and physical health, increasing research also suggests that a protective relationship exists between positive psychological functioning and physical health (Diener & Chan, 2011;Pressman & Cohen, 2005). Because the effects of psychological well-being and psychological ill-being are not merely opposites of one another and the absence of one does not necessarily indicate the presence of the other (Ryff et al., 2006;Ryff & Singer, 1998), it is critical to consider each separately in rel...

Affect dynamics across the lifespan: With age, heart rate reacts less strongly, but recovers more slowly from unpleasant emotional situations.

“…The measurement of general responses to emotional situations may conflate age differences in reactivity and/or recovery if the beginning and the end of the situation is unknown-that is, the end of reactivity and the beginning of recovery. The additional focus on recovery offers an extended approach regarding affective responses to, and health-related outcomes of, emotional experiences (Boehm & Kubzansky, 2012;Davidson, 1998;Wrosch, Miller, Lupien, & Pruessner, 2008). It was partly motivated by theoretical accounts associating recovery time with a vulnerability to psychopathology (Davidson, 1998), and by previous research showing that heart rate recovery after physical exercise proved valuable to predict mortality among middle-aged and older adults (Nishime, Cole, Blackstone, Pashkow, & Lauer, 2000).…”

Is flourishing good for the heart? Relationships between positive psychol characteristics and cardiorespiratory health.[¿Es la salud psicológica buena para el corazón? Relación entre características psicológicas positivas y variables cardiorrespiratorias]

“…Further studies pointed out that positive psychological constructs might also be associated with atherosclerosis and calcification (Matthews, Owens, Edmundowicz, Lee, & Kuller, 2006;Matthews, Räikkönen, Sutton-Tyrrell, & Kuller, 2004). However, these results are also inconsistent and most of the findings on these associations were related to only a small number of positive psychological attributes and were based on the same database of a single cohort of women (Boehm & Kubzansky, 2012).…”

“…However, our knowledge is limited and inconsistent about the specific biological means through which these components of human flourishing may be associated with the etiology and progression of heart diseases. For instance, most of the work on the physiological correlates of positive attributes has focused on optimism or transitory positive states, investigated either clinical or healthy populations, and their samples often consisted of only one sex (Boehm & Kubzansky, 2012;DuBois et al, 2012).…”

“…The results showed that positive psychological attributes were associated with reduced risk of coronary heart disease and cardiovascular mortality especially in older populations (Boehm & Kubzansky, 2012;Chida & Steptoe, 2008;DuBois et al, 2012). The examined constructs extended from satisfaction with life (Boehm, Peterson, Kivimaki, & Kubzansky, 2011b) to sense of coherence (Surtees, Wainwright, Luben, Khaw, & Day, 2003), through perceived meaning in life (Seki, 2001) or dispositional optimism (Giltay, Geleijnse, Zitman, Hoekstra, & Schouten, 2004;Tindle et al, 2009).…”

“…As part of these efforts, a wider range of positive psychological variables was investigated in the present study including both eudaimonic, hedonic, and mixed nature indicators (Boehm & Kubzansky, 2012) providing the opportunity to compare the strength of associations of these (groups of) attributes with cardiovascular functioning. Furthermore, several measures of cardiorespiratory functioning were used simultaneously in a clinical and a healthy sample consisting of both males and females to avoid the bias of many previous investigations that resulted from the examination of only one clinical status and/or sex.…”